Type 2 and sleeve gastrectomy success

Type 2
1

Hi all! I don't want to start a controversy here, I just want to share my own experience. I'm not giving anyone advice on what to do and I don't know if my story will be the same in a year or 10 years. But here goes.

I have had type 2 diabetes since 2005. Probably earlier, but they called what I had "pre-diabetes" or "insulin resistance" back then. I have been about 100 pounds overweight for many years now. Yes, I did all the diets, eating healthy, exercise. But I couldn't KEEP much weight off long-term. I was pretty normal in that way.

Through all of this, my diabetes has been extremely manageable. My highest a1c was around 7 and most of the time it was at or below 6. Sometimes I took metformin, but I had IBS and the metformin made it worse. The difference to my a1c with or without metformin was quite frankly not much. I realize I am a LUCKY diabetic since I have not seen much degeneration of pancreatic function since diagnosis.

Well, in the last year I have seen some scary (for me) blood sugars. Fewer 5s, more 7s,and quite a few 8s and 9s. (Sorry, I am in Australia and only use mmol/l). While these are certainly not put-you-in-hospital numbers, they were scary to me, because they signaled that my diabetes honeymoon was coming to an end.

On the advice of my doctor, I began considering weight loss surgery. I am not exaggerating when I say that I have tried every non-fad diet out there. I generally lost weight but could not sustain the weight loss. I even did a medically supervised liquid diet (Optifast 800) for 14 months, from September 2011 to December 2012. This program included comprehensive dietetic advice with weekly one-on-one meetings, as well as several therapy sessions. On Optifast, I lost 40 pounds. By January 2013 I had gained 20 back, while doing the right things at least 80% of the time.

The failures with weight loss and the worsening blood glucose levels made me open to the idea of weight loss surgery. I decided on the sleeve gastrectomy because it is permanent, does not reroute the intestines or rely on malabsorption, and doesn't leave any foreign materials in the body. After extensive research and soul-searching, I had the surgery on May 14, 2013. Thus, I am a week and a half out from surgery.

During and immediately after the surgery, my blood glucose hovered around 7, elevated by the IV fluids and stress on my body. By the second day, I was seeing mid-5s. By the third day, my numbers were holding steady at 4.9. The whole first week, two hours post-prandial and morning fasting, I saw 4.9. This morning, my fasting number was 4.7. That number is what encouraged me to share this post with you today.

Now, I am still on full fluids. I am drinking 3 meal-replacement high-protein shakes per day. These are also relatively high in carbs. They would normally be quite a challenge to my system. I am also drinking fruit juice and dairy which wouldn't help either. My doctor has instructed me not to take metformin for the first three months so we can see what happens. It might be that when I go onto "real food" next week, my numbers bounce back up into the 5s or higher.

But I don't think so. There are countless studies showing improvement in blood glucose following weight loss surgery, specifically the sleeve gastrectomy and the gastric bypass. These improvements show up even before weight loss, and the mechanisms for them are not fully understood. I Salian resistance seems to be improved very quickly by these surgeries.

I'm not saying weight loss surgery is necessarily a cure for diabetes or puts it I to remission. It may be that I have only bought myself a few weeks, months, or years. I will commit to provide updates of my progress over time. For now, I could not be more pleased.

Update: please read the comments to see my follow-ups so far. I am now four months post-op and so far the story keeps getting better and better.

Update: I have passed the 6-month mark, my numbers are still non-diabetic, and I have lost 30 kg. more details in my latest comment.

Update: Just past 8 months and my doctor ordered a full battery of tests, including a Glucose Tolerance Test. He considers me to no longer have Type 2 diabetes, based on the results of the GTT, and all of my numbers (cholesterol, vitamins, minerals, hormones) are currently perfect. See more details in the comments. I am so grateful for this surgery! Even if I am not "cured" forever, any time I can give my body with normoglycemic blood will be a huge benefit.

Update: I passed the one-year mark two weeks ago on May 14 and I'm still doing great. Maintaining my weight-loss and diabetes is still in remission. See the comments for more details.
2

Thank you for sharing your journey. I wish you well with your numbers. please keep us posted about how you do. Good luck. Nancy

3

Its great that the surgery worked well for you. It can definitely help overweight type 2s better their glucose levels and stuff like lowering heart disease and such. Just to clarify though, type 2s don’t have a “honeymoon” period like type 1s have. Most people’s glucose spikes because of carbs. So don’t be surprised or frustrated if your readings are still higher than 4s 5s when you start eating real foods again. Hope you’re doing well.

4

Thank you most kindly for sharing. I have been most curious on how the sleeve works out as I understand it is a far simpler approach.

If I may ask; have they put you on a restricted diet as well and/or a restriction period and than gradually increase food?

Best wishes and good luck for your health.

5

Yes that’s correct. It is to allow the stomach to heal. Different surgeons have different protocols, but I am on what I think is the most common. Two weeks free fluids, with 3 meal replacement shakes a day (Optifast) and other things that fit through a straw. Then two weeks purée foods, which are normal foods blended smooth with the consistency of mashed potatoes and containing roughly half lean meat. Then two weeks soft foods, which cam be cut with the side of a fork. Then normal foods as tolerated. I will start out holding about 1/4 cup per meal so have 6 meals per day. After a year I will be having 3 or 4 1-cup meals a day. Maintenance will be tweaking the calories upward just until I stop losing.

6

Misty:

Special thanks for sharing details. My read is that one ( and this applies to anybody doing tight diets or wanting to stop type 2 )must be sure not to overload the calories to body as that is required to retain these benefits.

This has been most interesting, as I and a class I attend had the manager of the Bariatric Surgey Department of a major hospital share their details with us in a T2 diabetic class.

Best wishes for every success and good health while helping us to learn,

7

Whoops, I managed to submit an empty reply. Odd.

Anyway, I started the puree food stage on Tuesday. Today is Thursday. My 2-hour post-prandials have remained in the high 4s. Two hours after breakfast this morning, 4.7. Breakfast was a puree of pumpkin, ricotta, a bit of sugar, a bit of Benefiber fiber supplement, and some spices.

After bariatric surgery, the emphasis is on a high-protein low-fat diet for quite some time, and for life to a larger extent. The stomach capacity is greatly reduced, so in order to get in your protein, you are instructed to eat it first in your meal, then eat vegetables, then if you still have room left over, have some bread, potatoes, or other "fun" food.

Currently, my meal portions are 1/2 cup. Here is a sample menu:

Breakfast: Pumpkin ricotta puree
Morning snack: Applesauce with protein powder mixed in, coffee
Lunch: Chicken rice casserole puree
Afternoon: Tuna casserole puree, protein shake as a drink throughout the afternoon
Dinner: Chicken burrito puree
Evening: Small glass of fruit juice, or 100% fruit ice "pole" (70 mL), or small container of Yakult drinkable yogurt

The purees are made with roughly half meat or protein source, and half "other stuff". A half cup of one of the purees is roughly 100 calories. I am getting around 600 calories per day and I am very full all the time. I have to set timers to remind me to eat and drink. I am also getting in 7-8 glasses of liquid, mostly water.

So far I have lost 6 kg (around 13 lb).
I will come back and update in a couple weeks when I start the "soft food" stage.

8

Misty:

Many special thanks for sharing details with us and your progress.

I wish you best of good health, luck and progress.

Your sharing is gratiously appreciated.

9

I’m at 5 weeks, have been on full food for two weeks. I had a small pancake with syrup, an egg, and 1/8 avocado for breakfast. 28 grams of carbs. Two hours later, blood glucose is 4.8. So even with adding more carbs back in, it has been smooth sailing. I will keep y’all posted as I go.

10

Thanks for keeping us posted, I wish you continued success.

11

joining stemwinder to offer continued best wishes and good health. Thank you for sharing.

12

I'm glad you've found something that is working for you! Good luck for the future.

13

I am now four months post-surgery and eating all types of food without restriction. I am averaging around 850-900 food calories per day, around 40 grams of protein and around 60 grams of carbs. This intake is spread across four meals per day. In addition, I am running three times a week, about 30 minutes per run. Weight training twice a week, once upper body and once lower.

I have lost 21 kg and have brought my BMI from 43 to 34.4. My fasting blood glucose level hovers around 4 mmol/l and two-hour post-prandial around 4.5. I haven’t had an A1C taken since surgery but I’m due. My GP wants me to take a GTT because he suspects that he can strike diabetes from my official medical diagnosis.

In addition, cholesterol and blood pressure are “textbook perfect.”

I know that this could just be a respite from diabetes and my pancreatic function could still degrade. I’m only 35 and I hopefully have a lot of years left. But right now I am very thankful for these outcomes and I feel fortunate to have had the opportunity to have bariatric surgery.

14

Good for you!

15

I have passed the 6-month mark, lost over 30 kg, and my post-prandial glucose reading is still in the neighborhood of 4.7 to 5.2. I’m eating around 1000 calories a day, at least 60 grams of protein and less than 150 grams of carbs. I have probably reached my stomach’s new normal volume, as all of the swelling is typically gone by the 6-month mark and the stomach has fully relaxed. Unlike the gastric bypass, the sleeve does not stretch over time.



All of my blood work is great and I’m running about 20 km a week. I still would like to lose about 15 more kg, to put me in the middle of the healthy BMI range.



I had to have my gallbladder removed, which is a very normal complication for people who lose a significant amount of weight. No other trouble.

16

Misty Great news. Glad to hear of the great progress. I am very pleased to hear of the results and you are doing good. Best wishes and continued good health.

17

I’m now 8 months post-op. Today I received the results of a full blood work-up, a1c, and two-hour glucose tolerance test.

My vitamins and minerals are perfect. My cholesterol is exemplary.

And my glucose numbers? A1C is 4.2. Fasting glucose is 4.0. One hour after 75 grams of glucose, my blood glucose was 5.2. Two hours afterward, it was 2.7. Yes there is probably a but of reactive hypoglycemia there, but that is a tough test. My GP is labeling me as no longer diabetic. Of course this could just be a respite. But an 8-month break from diabetes seems like a godsend to me. I hope it lasts the rest of my life!

I’m still having fewer than 100 grams of carbs daily, and sticking to that regime quite easily. I am now eating between 1000 and 1200 calories per day. To eat more, I would need to increase the fat content of my diet. As it is, I don’t feel hungry in the least and my blood chemistry does not show any deficiencies. I’ll try to remember to update at further milestone dates.

18

awesome news Misty! Congratulations!

19

That's a great result! Thanks for sharing your interesting story!!

20

Great work Misty. Blessings for sharing your story and success.

At some point, the knuckleheads in the science profession are going to realize that the modern diets and food of our society are overwhelming the super efficient hunter gatherer body and gene set with excess energy. If only we all were still walking around Germania for the Roman army or the Pharaoh's stone working projects cranking out 2 ton stone blocks by hand - possibly.